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Trends in Glycemic among Youth with Diabetes: The SEARCH for Diabetes in Youth Study

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posted on 10.01.2022, 21:40 authored by Faisal S. Malik, Katherine A. Sauder, Scott Isom, Beth A. Reboussin, Dana Dabelea, Jean M. Lawrence, Alissa Roberts, Elizabeth J. Mayer-Davis, Santica Marcovina, Lawrence Dolan, Daria Igudesman, Catherine Pihoker, the SEARCH for Diabetes in Youth Study
OBJECTIVES: To describe temporal trends and correlates of glycemic control in youth and young adults (YYA) with youth-onset diabetes.

RESEARCH DESIGN AND METHODS: The study included 6,492 participants with type 1 or type 2 diabetes from the SEARCH for Diabetes in Youth study. Participant visit data were categorized into time periods 2002-2007, 2008-2013 and 2014-2019, diabetes durations of 1-4, 5-9, and 10+ years, and age groups 1-9, 10-14, 15-19, 20-24, 25+ years. Participants contributed one randomly selected data point to each duration and age group per time period. Multivariable regression models were used to test differences in hemoglobin A1c (HbA1c) over time by diabetes type. Models were adjusted for site, age, sex, race/ethnicity, household income, health insurance status, insulin regimen and diabetes duration, overall and stratified for each duration and age group.

RESULTS: Adjusted mean HbA1c for the 2014-2019 cohort of YYA with type 1 diabetes was 8.8%±0.04%. YYA with type 1 diabetes in the 10-14, 15-19, and 20-24 age groups from the 2014-2019 cohort had worse glycemic control than the 2002-2007 cohort. Race/ethnicity, household income and treatment regimen predicted differences in glycemic control in 2014-2019 type 1 diabetes participants. Adjusted mean HbA1c was 8.6%±0.12% for 2014-2019 YYA with type 2 diabetes. Participants age 25+ with type 2 diabetes had worse glycemic control relative to the 2008-2013 cohort. Only treatment regimen was associated with differences in glycemic control in type 2 diabetes participants.

CONCLUSIONS: Despite advances in diabetes technologies, medications, and dissemination of more aggressive glycemic targets, many current YYA are less likely to achieve desired glycemic control relative to earlier cohorts.


Funding

SEARCH 4 The SEARCH for Diabetes in Youth Cohort Study (1R01DK127208-01, 1UC4DK108173) is funded by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases and supported by the Centers for Disease Control and Prevention. The Population Based Registry of Diabetes in Youth Study (1U18DP006131, U18DP006133, U18DP006134, U18DP006136, U18DP006138, U18DP006139) is funded by the Centers for Disease Control and Prevention (DP-15-002) and supported by the National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. SEARCH 1-3: SEARCH for Diabetes in Youth is funded by the Centers for Disease Control and Prevention (PA numbers 00097, DP-05-069, and DP-10-001) and supported by the National Institute of Diabetes and Digestive and Kidney Diseases. Kaiser Permanente Southern California (U48/CCU919219, U01 DP000246, and U18DP002714), University of Colorado Denver (U48/CCU819241-3, U01 DP000247, and U18DP000247-06A1), Cincinnati's Children's Hospital Medical Center (U48/CCU519239, U01 DP000248, and 1U18DP002709), University of North Carolina at Chapel Hill (U48/CCU419249, U01 DP000254, and U18DP002708), Seattle Children's Hospital (U58/CCU019235-4, U01 DP000244, and U18DP002710-01] and Wake Forest University School of Medicine (U48/CCU919219, U01 DP000250, and 200-2010-35171). Investigator Support: Dr. Faisal Malik’s time was supported by a K23 Career Development Award from the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (DK119465).

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